妇宁康颗粒治疗产后子宫复旧不良的临床观察概要

河南中医学院2009届硕士研究生学位论文妇宁康颗粒治疗产后子宫复旧不良的临床观察研究生姓名:郭华林导师:李京枝主任医师指导组成员:申霞主任医师崔翠林副主任医师学科、专业:中医妇科学所属院、系:第一临床医学院中国﹒郑州2009年4月30日硕士学位论文原创性声明本人所呈交的硕士学位论文,是在导师教授(主任医师、研究员等的指导下,独立进行科学研究工作所取得的成果。除文中已特别加以注明引用的内容外,论文中不包含任何其他个人或集体已经发表或撰写过的研究成果。对本文的研究做出重要贡献的个人和集体,均已在文中以明确方式标明并致谢。本人完全意识到本声明的法律结果由本人承担。特此声明。论文作者(签名:年月日硕士学位论文使用授权声明本人已完全了解河南中医学院有关保留、使用硕士学位论文的相关规定,同意学校保留或向国家有关部门、机构送交本学位论文的复印件和电子版,允许论文被查阅或借阅。本人授权河南中医学院可以将本论文的全部或部分内容编入有关数据库进行检索,可以采用影印、缩印或其他复制手段保存、汇编本论文(注:保密论文在解密后适用本授权声明。特此声明。论文作者(签名:导师(签名:年月日年月日目录摘要(1英文摘要(3前言(5对象与方法(71一般资料(72诊断标准(83纳入标准(94排除标准(95病例剔除、脱落及中止实验标准(96中医症状分级标准(97疾病程度分级标准(108分组与方法(119观测指标(1110疗效判定标准(1111统计学处理(12结果(131疗效性观察(132相关性观察(133安全性观察(154疗效性分析(155安全性分析(156结语(15理论探讨论(17参考文献(24结论(26致谢(27附录1:文献综述(28摘要摘要子宫复旧不良,根据其主要临床表现,可见于中医的“产后血崩”,“产后恶露不绝”及“产后血晕”等各病中。产后恶露,在正常情况下,一般在二十天内便完全排尽,产后血性恶露持续3周或以上仍淋漓不断者,有时可大量出血,有臭味,血性恶露减少以后,还可能有炎性分泌物排出,盆腔检查发现子宫体积偏大,质地柔软,子宫多为后位,宫底和(或宫旁有压疼,宫颈充血,宫口未闭,西医称之为“子宫复旧不良”,中医称之为“恶露不绝”、“恶露不止”、又称“恶露不尽”。子宫复旧不良是产科领域中的常见病症,以产后子宫复缩欠佳,恶露过多,持续时间延长为主要表现,直接影响到产妇的身心健康和生活质量。本课题主要研究气虚血瘀型子宫复旧不良,即气虚血瘀型产后恶露不绝。临床实践我们己经证实妇宁康颗粒用于治疗气虚血瘀型产后子宫复旧不良具有较好的效果,现为了进一步探讨其作用机理:1目的本课题以中医理论为指导原则,通过对气虚血瘀型产后子宫复旧不良的患者治疗前后临床症状的系统全面的观察,采用益气养血,祛瘀止血法治疗气虚血瘀型产后子宫复旧不良。观察妇宁康粒治疗气虚血瘀型产后子宫复旧不良的临床疗效及安全性,为妇宁康颗粒的临床应用提供科学依据。2方法选用60例确诊为气虚血瘀型产后子宫复旧不良的患者,随机分为妇宁康颗粒治疗组和新生化冲剂对照组,每组30例。观察方法为随机单盲双模拟对照,连续服药7天为1疗程。用药1疗程后观察治疗前后两组患者的临床症状改变、子宫复旧情况变化、血常规变化及安全性。3结果3.1治疗气虚血瘀型子宫复旧不良的止血疗效妇宁康颗粒治疗组治愈率33.33%,显效率30.00%,有效率30.00%,总有效率93.33%。新生化冲剂对照组治愈率26.67%,显效率40.00%,有效率26.67%,总有效率93.33%。两组通过统计学处理,无显著性差异,都具有很好的止血疗效。3.2治疗气虚血瘀型子宫复旧不良的证候疗效妇宁康颗粒治疗组治愈率33.33%,显效率33.33%,有效率30.00%,总有效率96.67%。新生化冲剂对照组治愈率33.33%,显效率30.00%,有效率30.00%,总有效率93.33%。两组通过统计学处理,无显著性差异,都具有很好-1-妇宁康颗粒治疗产后子宫复旧不良的临床观察的疗效。3.3两组组内盆腔B超子宫体积(子宫三径测量法治疗前后比较均有显著性差异,组间治疗前、后子宫体积比较均无显著性差异,表明两组药物在改善子宫复旧方面都有很好的疗效且无显著性差异。4结论妇宁康颗粒能有效治疗气虚血瘀型产后子宫复旧不良,能明显地改善产妇恶露持续时间、量、色、质,小腹疼痛及舌象、脉象等相关临床症状,促进子宫复旧。临床应用安全有效,无毒副作用。关键词:产后子宫复旧不良,气虚血瘀型,临床观察,妇宁康颗粒-2-前言Ningkanggranulesinthetreatmentofpost-natalwomenUterineinvolutioninclinicalobservationofnon-performingGuoHualin(GynecologyofTraditionalChineseMateriaMedicaDirectedbyLiJingzhiAbstractUterineinvolutionbad,accordingtoitsmainclinicalmanifestations,canbefoundintraditionalChinesemedicine'spost-natalflooding,postpartumlochianeverandpost-natalbloodhaloandotherdisease.Postpartumlochia,undernormalcircumstances,generallywithin20daystodoitcompletelyPai,bloodylochiapostpartumsustainedthreeweeksormoreisstilldrippingconstantly,andsometimessubstantialbleeding,haveodor,bloodylochiaafterreduction,butalsomayhaveinflammatoryexudatesdischarged,pelvicexaminationrevealedtheuterusthantheperiodshouldbelarge,andsoft,andoftentheuterusforthepost,andPalaceattheendofand(orhaspressurepain,cervicalhyperemia,Miyaguchiductus,WesternmedicineasPostpartumuterineinvolutionbad,Chinesemedicinecalledlochianever,alsoknownaslochianot.UterineinvolutionarebadintheareaofcommonobstetricdiseasesinordertoshrinkuterusRehabuspoortoolochia,durationextendedasthemainperformance,adirectimpactonmaternalphysicalandmentalhealthandqualityoflife.OurclinicalpracticehasbeenconfirmedforthetreatmentofwomenNingkangparticlesqideficiencyandbloodstasisuterussubinvolutionbadwithgoodresults,itisinordertofurtherexploreitsmechanism,especiallytodothefollowingresearch:Objective:TopresentthesubjectofChinesemedicinetheoryastheguidingprinciplesofpost-partumuterineinvolutioninpatientswithadverseclinicalsymptomsbeforeandaftertreatmentofsystematicandcomprehensiveobservation,usingYiqiYangxue,QuyuhemostasisQideficiencyandbloodstasistreatmentofpostpartumuterineinvolutionadverse.ObservationofQiDeficiencyFuNingkangtabletsofthetreatmentofuterineinvolutionpostpartumbloodstasisadverseclinicalefficacyandsafetyforwomenNingkangparticlestoprovideascientificbasisforclinicalapplication.Methods:60casesdiagnosedasbloodstasisvirtualadversesubinvolutionuteruswere妇宁康颗粒治疗产后子宫复旧不良的临床观察randomlydividedintotreatmentgroupWomenNingkangparticlesandXinshenghuaChongjicontrolgroup,30casesofeachgroup.Observationmethodsforrandomized,double-blinddouble-dummycontrolled,thefirstdayofpost-partummedication,medicationfor7daysforonecourseoftreatment.medicationafteronecourseoftreatmentwereobservedbeforeandaftertreatmentinpatientswithclinicalsymptomschangesubinvolutionuteruschanges,bloodchangesandsecurity.Results:1TreatmentofbloodstasissubinvolutionuterinebleedingadverseeffectsFuNingkangparticletreatmentgroup33.33%curerate,markedlyeffectiveratewas30.33%,30.00%efficient,withatotalHas93.33%efficiency.NewbiochemicalChongjicontrolgroup26.67%curerate,markedlyeffectiveratewas40.00%has26.67%efficiency,Thetotaleffectiverate93.33%.Thetwogroupsthroughthestatisticaltreatment,nosignificantdifference,haveaverygoodtreatmenttostopbleedingEfficiency.2TreatmentofuterinebloodstasissyndromesubinvolutionadverseeffectWomenNingkangparticletreatmentgroup33.33%curerate,markedlyeffectiverate33.33%,30.00%efficient,withatotal9has96.67%efficiency.NewbiochemicalChongjicontrolgroup33.33%curerate,markedlyeffectiveratewas30.00%,30.00%efficient,thetotaleffectiverate93.33%.Onestudygroupsthroughstatisticaltreatment,nosignificantdiffer